Individual provider Active NPI

Samantha Ariel Spielfogel, PSYD

  • Clinical Psychologist
  • La Crescenta, CA
National Provider Identifier
1902448921
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY35675 Issued in CA
Practice address
2512 Foothill Blvd
La Crescenta, CA 91214-3506
Phone
(818) 583-7134
NPI assigned
Oct 10, 2019
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X PSY35675 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X NU
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2512 Foothill Blvd
La Crescenta, CA 91214-3506

Mailing address

2512 Foothill Blvd
La Crescenta, CA 91214-3506
Phone (818) 583-7134

Other practice location 1

919 1st St
San Fernando, CA 91340-2957
Phone (818) 256-1124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219003095 CA Practitioner - Clinical Psychologist 0749700854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katie Enney Psychologist IncGroup PAC ID 0941580930, 3 clinicians

Practice addresses (Care Compare)

2512 Foothill Blvd
La Crescenta, CA 91214-3506
Phone (818) 583-7134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY35675CAMDClinical Psychologist
35675CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Katie Enney Psychologist Inc Psychologist CurrentSince Feb 13, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1902448921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143506",
            "telephone_number": "818-583-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143506",
            "telephone_number": "818-583-7134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 1st St",
            "address_purpose": "LOCATION",
            "city": "San Fernando",
            "state": "CA",
            "postal_code": "913402957",
            "country_code": "US",
            "telephone_number": "818-256-1124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIELFOGEL",
        "first_name": "SAMANTHA",
        "middle_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35675",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.